Cost and Reimbursement Comparison Schedule for FY 2015-16
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Submission Deadline
The resubmission deadline for the Cost and Reimbursement Comparison Schedule (CRCS) for Fiscal Year 2015-16
is
June 30, 2022.
Direct Medical Services Percentage
Consortia 1, 2, 7: Sonoma - Glenn - Madera
| 49.61%
|
Consortia 3, 4, 5, 6: Sutter - Contra Costa - Santa Cruz - Stanislaus
| 51.88%
|
Consortia 8, 9: Kern - Orange
| 51.90%
|
Region 10: San Bernadino
| 48.35%
|
Region 11: Los Angeles
| 52.41%
|
LGA Consortia
| 49.02%
|
Mandatory CRCS Requirement:
Participants in the LEA Medi-Cal Billing Option (LEA BOP) are required to annually certify, through the CRCS process, that the public funds expended to provide LEA BOP services are eligible for federal financial participation. Therefore, continued enrollment in the LEA BOP is contingent upon timely submission of the CRCS each fiscal year. Failure to meet this requirement may result in suspension from the LEA BOP.
LEA Annual Reimbursement Report:
Note: The LEA Annual Reimbursement Report will assist LEAs to complete CRCS Worksheets A-4 and B-4. LEAs should verify the reasonableness between your internal accounting system and the LEA Annual Reimbursement Report and accurately input encounters, units and reimbursement information for each procedure code/modifier combination on your CRCS form. Potential discrepancies between the LEA Annual Reimbursement Report and your internal system numbers should be documented to support the numbers you input on the CRCS forms and to provide an accounting documentation trail for review and audit.
FY 2015-16 CRCS and Certification of Zero Reimbursement Forms:
Additional CRCS Resources:
LEA Reimbursement Rates:
-
FY 2015-16 No Rate Change:
Required Documentation:
DHCS Audits and Investigations (A&I) staff will conduct a desk or field audit of the CRCS to determine the final settlement amount. Supporting documents must be maintained by each LEA for a minimum of three years from the date of final submission of the CRCS. These documents must be verifiable by A&I. LEA providers may appeal the determinations made by DHCS pursuant to
Welfare and Institutions Code, Section 14171.
CRCS Submission Process:
Excel version of the completed CRCS form (all worksheets)
Scanned version of the original signed CRCS form (i.e., PDF, JPEG, etc.)
CRCS electronic files and the subject line of the email must follow this naming convention: Fiscal
Year.NPI Number.Business LEA
Name.Submission Date
-
CRCS Fiscal Year Example: FY1415.1234567890.SampleSchoolDistrict.06.30.2022.CRCS.XLS (or .PDF)
LEAs are required to maintain the original hard copy CRCS with all worksheets and the Certification page signed in blue ink on site for DHCS A&I audit purposes, if necessary.
Audit Review and Analysis Section (ARAS) of A&I
is implementing a 100% reimbursement withhold on providers who are more than 30 days past the due date of the CRCS. The 100% withhold will be lifted once the delinquent CRCS has been submitted and has passed the acceptance review.
CRCS Questions/Contacts:
